In March, Barbara Prescott turned 84. A Cape Cod resident, Barbara has always enjoyed exercise and going for walks in her community.
So, when she began feeling intense pain radiating down the right side of her body and crossing over to her left lower leg, she knew she had to do something about it. Describing her pain, Barbara said, “I’ve had 5 kids, and that pain was the worst I’ve had.”
Visiting her friends at Tufts Medical Center
After toughing it out for a few months, Barbara called Carl Heilman, MD, Chief of Neurosurgery at Tufts Medical Center. Barbara had seen Dr. Heilman and neurosurgeon Julian Wu, MD, back in 1999 when she was diagnosed with a meningioma after a routine neurological workup.
“Back in 1999, I sat with Dr. Heilman as we reviewed my brain MRI and he explained what it meant and clearly shared what my treatment options were,” shared Barbara. “He and Dr. Wu then performed a 17-hour surgery to save my life. I was fortunate. So, when I had a scan of my back this year after feeling that radiating pain, I sat down with Dr. Heilman again to review the results.”
The scan showed that Barbara’s L4 and L5 vertebrae had been completely separated, a sign of a condition called spinal stenosis. After reviewing her spine MRI, Dr. Heilman told Barbara she had two options. “She could have surgery, which has its risks but could get her back to doing the things she loves,” he said. “Or, her prognosis was a walker, possibly a wheelchair and constant pain.”
Dr. Heilman then referred Barbara to see one of his colleagues, spine surgeon James Kryzanski, MD. After reviewing Barbara’s scan, Dr. Kryzanski came to the same conclusion – that surgery was the best option for Barbara and the quality of life that she expects.
An innovative surgical plan
After talking over the benefits and risks with Barbara and her family, Dr. Kryzanski recommended a spinal fusion. During this procedure, the surgeon permanently joins unstable vertebrae using metal screws and rods that work like an internal brace to keep the bones in your back in the correct position
Barbara and her daughter, who is a nurse, were worried about anesthesia but Dr. Kryzanski had a solution for that too. “In older patients, general anesthesia is associated with postoperative confusion and delirium.” Dr. Kryzanski explained. “Certain patients even have a permanent decline in their mental faculties. Using spinal anesthesia we avoid general anesthesia altogether and eliminate these issues. There are special considerations when performing spinal surgeries under spinal anesthesia and so we have developed a multidisciplinary program unique to Tufts MC.”
Dr. Kryzanski is one of a few surgeons in Boston who are currently offering this approach of providing anesthesia directly to the spine but studies have shown that it’s safer and leads to less complications.
“Barbara did fantastic during surgery,” Dr. Kryzanski continued. “We used spinal anesthesia and she was awake but comfortable during surgery. She had a very smooth postoperative course without grogginess, nausea, or other typical side-effects of general anesthesia”
Back to the things she loves
“I had an easy time in and out of surgery,” Barbara agreed. “They had specialists for me in case I needed it and they made me a part of my care team. They helped me prepare emotionally, spiritually and physically for the surgery and recovery. They were all wonderful."
Since the surgery, Barbara hasn’t had any pain and is back to the things she loves. “I happen to enjoy exercise and I’m getting back into it thanks to the care I received – it was superb.”